Syncope in paced patients with sick sinus syndrome from the DANPACE trial: incidence, predictors and prognostic implication
Syncope in paced patients with sick sinus syndrome from the DANPACE trial: incidence, predictors and prognostic implication
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DOI：
10.1136/heartjnl-2013-304976
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发表时间：
2014-06-01
期刊：
影响因子：
5.7
通讯作者：
Nielsen, Jens Cosedis
中科院分区：
文献类型：
--
作者：
Chuen, Marie Jennyfer Ng Kam;Kirkfeldt, Rikke Esberg;Nielsen, Jens Cosedis
晕厥是病窦综合征（SSS）的重要发病原因，可能无法通过永久性起搏器治疗来解决。我们的目的是确定SSS患者晕厥的发生率、预测因素和预后意义。方法：我们研究了1415例SSS患者（平均年龄72.9岁，SD 11.1），这些患者在DANPACE研究中被随机分为速率反应性单室起搏组（n=707）和速率反应性双室起搏组（n=708）。主要观察指标为患者报告的起搏器植入后晕厥和死亡率。结果平均随访5.4年（SD 2.6）。共有247例（17.5%）患者在植入起搏器后出现晕厥，其中单室起搏器组135例（19%），双室起搏器组112例（15.8%）。起搏器植入后晕厥的预测因素包括：年龄0 ~ 39岁（HR 2.9, 95% CI 1.4 ~ 6.3, p=0.01；参考范围60 ~ 79岁），年龄80岁（HR 1.4, 95% CI 1.0 ~ 1.8, p=0.03），植入起搏器前晕厥（HR 1.8, 95% CI 1.4 ~ 2.3, p=0.03）
Objectives Syncope is a cause of significant morbidity in sick sinus syndrome (SSS) which may not be resolved with permanent pacemaker therapy. We aimed to determine the incidence, predictors and prognostic implication of syncope in paced patients with SSS.Methods We studied 1415 patients (mean age 72.9years, SD 11.1) with SSS who were randomised in the DANPACE study to either rate-responsive single chamber pacing (n=707) or rate-responsive dual chamber pacing (n=708). Main outcome measures were patient-reported syncope after pacemaker implantation and mortality.Results Mean follow-up was 5.4years (SD 2.6). A total of 247 (17.5%) patients experienced syncope after pacemaker implantation (135 (19%) from the rate-responsive single chamber pacing group, and 112 (15.8%) from the rate-responsive dual chamber pacing group. Predictors of syncope post pacemaker implantation included: age 0-39years (HR 2.9, 95% CI 1.4 to 6.3, p=0.01; reference range 60-79years), age 80years (HR 1.4, 95% CI 1.0 to 1.8, p=0.03), syncope prior to pacemaker implant (HR 1.8, 95% CI 1.4 to 2.3, p